A prospective study to compare the aspiration and non aspiration techniques in fine needle cytology of lymphnode and to evaluate the diagnostic accuracy of aspiration cytology in lymphnode lumps

Authors:K.Bharathi , S. Anuratha, Abdul Khalique, Sudha Venkatesh
Int J Biol Med Res. 2012; 3(3): 2147-2152  |  PDF File

Abstract

Background: Fine needle cytology is an efficient alternative to the surgical excision in case of lymphnode lumps. Objectives: The aim of this study was to compare the cytological features of fine needle non- aspiration cytology (FNNAC) with that of fine needle aspiration cytology (FNAC) in lymphnode lumps and to evaluate the diagnostic accuracy of fine needle cytology. Methods: Samples were obtained by applying both FNAC and FNNAC techniques, from lymphnode lumps of 100 patients who attended the cytology department. The sampling procedures were done by single operator after getting a written consent. The slides were studied and reported by an expert cytologist, thus bias was avoided in all stages of the study from sampling to reporting. Slides obtained from FNAC and FNNAC techniques were compared using a objective scoring system developed by Mair et al based on the background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma and retention of appropriate architecture. In 30 cases aspirated lymphnode lumps were excised surgically and the diagnostic accuracy of fine needle cytology in lymphnode lesions was evaluated by doing histopathological correlation with cytological features. Wilcoxon signed rank test was performed using SPSS14 software for statistical analysis. Differences between FNAC and FNNAC based on the above mentioned five parameters were analysed. The diagnostic adequacy, quality of smears obtained from two techniques were compared. Results & Conclusions:. The number of unsuitable smears and failure rate was lower for FNAC technique. The diagnostic adequacy of FNAC ( 98%) is more than FNNAC technique (80%) and the difference is statistically significant (p<0.05). We conclude in our study that FNAC is the best choice as a diagnostic test for all the lymphnode swellings including cystic lesions The overall diagnostic accuracy of lymphnode cytology was 90%. The discordance rate was 10%. The sensitivity was 96.42%. The specificity was 66.66%.